A first party insurance claim is a claim made by an insured to his/her own insurance company. A common example of a first party claim would be if an insured’s roof was damaged by a hailstorm and the insured then submits a claim to his/her homeowner’s insurance carrier for the damage done to the roof.

When insurance companies are adjusting their customers’ insurance claims, they owe their insureds a common law duty of good faith and fair dealing as well as statutory duties codified in Chapters 541 and 542 of the Texas Insurance Code. This duty originated in the common law (from court case decisions rather than by statute) when the Texas Supreme Court first recognized a covenant of good faith and fair dealing between an insurer and its insureds based upon the parties special relationship with their insured. The public policy underlying the duty of good faith and fair dealing is that insurance companies are in a position to gain an unfair advantage over their insureds because of their superior knowledge, resources and bargaining power and therefore they have a “special relationship” with their policyholders and owe them a duty of good faith and fair dealing. Chapter 541 sets out Unfair Methods of Competition, Unfair or Deceptive Acts or Practices that insurance companies should not engage in, as well as Unfair Settlement Practices, which includes things like: misrepresenting a material fact or policy provision; failing to attempt in good faith to effect a prompt, fair and equitable settlement where the insurer’s liability has become reasonably clear; failing to provide a policyholder with a reasonable explanation of why a claim was denied or offer of compromise; and refusing to pay a claim without conducting a reasonable investigation. Chapter 542, subchapter B of the Texas Insurance Code is also known as the “Prompt Payment of Claims Act” and it provides insurance companies a blueprint for acting in “good faith.” For example, not later than the 15th day or, if the insurer is an eligible surplus lines insurer, the 30th business day after an insurer receives notice of the claim, the insurer shall: (1) an acknowledge receipt of the claim notice; (2) advise that an investigation of the claim is being commenced (and begin the investigation); and (3) ask the insured to provide the insurance company with documents and information necessary to adjust and evaluate the claim.

LIABILITY FOR VIOLATING CHAPTERS 541 AND 542 OF THE TEXAS INSURANCE CODE
The sections for violating Chapters 541 and 542 will be drastically changed to affect policy owners in favor of insurance companies. We are willing to answer and defend policy owners with regards to those changes.

We handle bad faith insurance claims for the following:

AIRCRAFT/AIRPORT

BUSINESS INTERRUPTION INSURANCE

CAR DEALERSHIPS

CHURCHES

GAS STATIONS AND CONVENIENCE STORES

GOVERNMENT BUILDINGS

GROCERY STORES

HOMEOWNERS AND PROPERTY OWNERS ASSOCIATIONS

HOTEL AND MOTEL

INDUSTRIAL BUILDINGS

MULTI-FAMILY APARTMENTS

OFFICE BUILDINGS

RETAIL PROPERTIES

SCHOOLS

We are ready to fight:

Unwarranted denial of coverage

Failure to communicate pertinent information to the claimant

Failure to conduct a reasonable investigation of the claim

Refusal to pay the claim without investigating

Failure to deny or pay the claim within a reasonable period of time

Failure to confirm or deny coverage within a reasonable period of time

Failure to attempt to come to a fair and reasonable settlement when liability is clear

Offering substantially less money to settle than the true value of the claim

Failure to promptly provide a reasonable explanation for denial of a claim

Failure to enter into any negotiations for settlement of the claim

Failure to respond to a time-limit demand

Failure to disclose policy limits

If your insurance company has denied or refuses to timely pay your insurance claim please call our offices at 888HDZLAW8. Get the Justice You Deserve from Experienced Trial Lawyers.